Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 10880 | OK |
N | 207QG0300X | Family Doctor - Geriatric Medicine | A03567 | AR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 75645 | OK |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 75645 | OK |
NPI | 1225339385 |
---|---|
Provider Name | Mrs. Rachel Veach |
First Address | Tulsa, OK 74104-5410 |
Second Address | Tulsa, OK 74104-5410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2010 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100134490A | (05) | OK |
448465500P | (02) | OK |